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https://www.readbyqxmd.com/read/28526011/risk-of-acute-kidney-injury-and-survival-in-patients-treated-with-metformin-an-observational-cohort-study
#1
Samira Bell, Bassam Farran, Stuart McGurnaghan, Rory J McCrimmon, Graham P Leese, John R Petrie, Paul McKeigue, Naveed Sattar, Sarah Wild, John McKnight, Robert Lindsay, Helen M Colhoun, Helen Looker
BACKGROUND: Whether metformin precipitates lactic acidosis in patients with chronic kidney disease (CKD) remains under debate. We examined whether metformin use was associated with an increased risk of acute kidney injury (AKI) as a proxy for lactic acidosis and whether survival among those with AKI varied by metformin exposure. METHODS: All individuals with type 2 diabetes and available prescribing data between 2004 and 2013 in Tayside, Scotland were included. The electronic health record for diabetes which includes issued prescriptions was linked to laboratory biochemistry, hospital admission, death register and Scottish Renal Registry data...
May 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28506290/pre-admission-functional-status-impacts-the-performance-of-the-apache-iv-model-of-mortality-prediction-in-critically-ill-patients
#2
James S Krinsley, Thomas Wasser, Gina Kang, Sean M Bagshaw
BACKGROUND: Functional status (FS) before intensive care unit (ICU) admission is associated with short-term and long-term outcomes among critically ill patients. However, measures of FS are generally not integrated into ICU-specific mortality prediction models. METHODS: This retrospective cohort study used prospectively collected data from 9638 consecutive patients admitted to a single ICU between 1 October 2005 and 30 September 2015. For each ICU admission, FS was prospectively determined and classified into three discrete categories based on performance of basic daily living activities (FS1 - fully independent; FS2 - partly dependent; FS3 - completely dependent)...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28499358/can-we-predict-functional-decline-in-hospitalized-older-people-admitted-through-the-emergency-department-reanalysis-of-a-predictive-tool-ten-years-after-its-conception
#3
Isabelle De Brauwer, Pascale Cornette, Benoît Boland, Franck Verschuren, William D'Hoore
BACKGROUND: In the Emergency Department (ED), early and rapid identification of older people at risk of adverse outcomes, who could best benefit from complex geriatric intervention, would avoid wasting time, especially in terms of prevention of adverse outcomes, and ensure optimal orientation of vulnerable patients. We wanted to test the predictive ability of a screening tool assessing risk of functional decline (FD), named SHERPA, 10 years after its conception, and to assess the added value of other clinical or biological factors associated with FD...
May 12, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28496266/computer-assisted-decision-support-for-student-admissions-based-on-their-predicted-academic-performance
#4
Eugene Muratov, Margaret Lewis, Denis Fourches, Alexander Tropsha, Wendy C Cox
Objective. To develop predictive computational models forecasting the academic performance of students in the didactic-rich portion of a doctor of pharmacy (PharmD) curriculum as admission-assisting tools. Methods. All PharmD candidates over three admission cycles were divided into two groups: those who completed the PharmD program with a GPA ≥ 3; and the remaining candidates. Random Forest machine learning technique was used to develop a binary classification model based on 11 pre-admission parameters. Results...
April 2017: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28491084/the-impact-of-optimal-medical-therapy-at-discharge-on-mortality-in-patients-with-coronary-artery-disease
#5
Shi-Jian Chen, Wei Liu, Bao-Tao Huang, Jia-Yu Tsauo, Xiao-Bo Pu, Yong Peng, Mao Chen, De-Jia Huang
OBJECTIVE: To analyze the current usage of optimal medical therapy (OMT), influencing factors, and the predictive value of OMT for all-cause mortality in coronary artery disease (CAD) patients with different subgroups. METHODS: A total of 3176 CAD patients confirmed by coronary angiography were included. OMT was defined as the combination of anti-platelet drugs, statins, beta blockers, and angiotensin converting enzyme inhibitors or angiotensin receptor blockers...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28483246/comparison-of-first-year-of-life-acute-otitis-media-admissions-before-and-after-the-13-valent-pneumococcal-conjugate-vaccine
#6
Tal Marom, Ofer Israel, Haim Gavriel, Jacob Pitaro, Ali Abo Baker, Ephraim Eviatar
BACKGROUND: Acute otitis media (AOM) is a common childhood infection, which is usually managed in the outpatient setting. Yet, the more severe cases are referred for inpatient treatment. We hypothesized that pneumococcal conjugate vaccines (PCVs), administered during the first year of life, would decrease AOM admissions rate in this age group. We studied the characteristics of infants admitted with AOM and acute mastoiditis (AM) in the PCV13 era, routinely given from November 2010 to all infants...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28475416/specific-clinical-profile-and-risk-factors-for-mortality-in-general-surgery-patients-with-infections-by-multi-drug-resistant-gram-negative-bacteria
#7
Ines Rubio-Perez, Elena Martin-Perez, Diego Domingo-García, Damian Garcia-Olmo
BACKGROUND: The incidence of gram-negative multi-drug-resistant (MDR) infections is increasing worldwide. This study sought to determine the incidence, clinical profiles, risk factors, and mortality of these infections in general surgery patients. PATIENTS AND METHODS: All general surgery patients with a clinical infection by gram-negative MDR bacteria were studied prospectively for a period of five years (2007-2011). Clinical, surgical, and microbiologic parameters were recorded, with a focus on the identification of risk factors for MDR infection and mortality...
May 5, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28471622/combination-of-corticosteroids-with-5-aminosalicylic-acids-compared-to-corticosteroids-alone-for-hospitalized-patients-with-active-ulcerative-colitis
#8
Ofir Har-Noy, Bun Kim, Rivi Haiat, Tal Engel, Bella Ungar, Rami Eliakim, Won Ho Kim, Jae Hee Cheon, Shomron Ben-Horin
BACKGROUND: Although 5-amino-salycilic acids (5-ASA) are often used with corticosteroid treatment in moderate-to-severe ulcerative colitis, the value of continuing/initiating 5-ASA in this clinical setting has not been explored. OBJECTIVES: To investigate the impact of a combination 5-ASA+corticosteroid therapy on the outcome of hospitalized patients with acute moderate-severe ulcerative colitis. METHODS: We conducted a retrospective study of patients hospitalized with moderate-severe ulcerative colitis in two centers, Israel and South Korea...
October 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#9
REVIEW
Nicola Ratto, Chiara Arrigoni, Federica Rosso, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia, Roberto Rossi
Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities...
September 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28460024/non-vitamin-k-dependent-oral-anticoagulants-have-a-positive-impact-on-ischaemic-stroke-severity-in-patients-with-atrial-fibrillation
#10
Simon Hellwig, Ulrike Grittner, Heinrich Audebert, Matthias Endres, Karl Georg Haeusler
Aims: Several studies showed reduced stroke severity in patients with atrial fibrillation (AF) if the international normalized ratio (INR) was ≥ 2 at stroke onset. There are no respective data for non-vitamin K-dependent oral anticoagulants (NOACs). The aim of this study was to compare the impact of NOAC or phenprocoumon intake on stroke severity. Methods and results: In this single-centre observational study, 3669 patients with acute ischaemic stroke were retrospectively analysed regarding AF status and medication immediately before admission...
April 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28416224/post-discharge-kidney-function-is-associated-with-subsequent-ten-year-renal-progression-risk-among-survivors-of-acute-kidney-injury
#11
Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, David McLernon, Gordon Prescott, Corri Black
The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes...
April 14, 2017: Kidney International
https://www.readbyqxmd.com/read/28372579/va-residential-substance-use-disorder-treatment-program-providers-perceptions-of-facilitators-and-barriers-to-performance-on-pre-admission-processes
#12
Laura S Ellerbe, Luisa Manfredi, Shalini Gupta, Tyler E Phelps, Thomas R Bowe, Anna D Rubinsky, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics...
April 4, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28369754/association-of-physician-specialty-with-hospice-referral-for-hospitalized-nursing-home-patients-with-advanced-dementia
#13
Claire K Ankuda, Susan L Mitchell, Pedro Gozalo, Vince Mor, David Meltzer, Joan M Teno
OBJECTIVES: Hospitalists hospice referral patterns have been unstudied. This study aims to examine hospice referral rates by attending type for hospitalized nursing home (NH) residents with advanced cognitive impairment (ACI) at the time of discharge between 2000 and 2010. DESIGN: Retrospective cohort study. PARTICIPANTS: Hospitalized NH residents age ≥66 drawn from the 20% sample of Medicare beneficiaries with ACI, 4 or more activities of daily living (ADL) impairments on last minimum data set (MDS) assessment completed within 120 days of admission (n = 128,989)...
March 28, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28344160/pre-operative-predictors-of-poor-outcomes-in-patients-undergoing-surgical-lower-extremity-revascularisation-retrospective-cohort-study
#14
Mohammed Ashrafi, Rohini Salvadi, Philip Foden, Stephanie Thomas, Mohamed Baguneid
BACKGROUND: Surgical lower extremity revascularisation (LER) can lead to poor outcomes that include delayed hospital discharge, in-hospital mortality, major amputations and readmissions. The aim of this study was to identify pre-operative predictors associated with these poor clinical outcomes. MATERIALS AND METHODS: All patients (n = 635; mean age 69; male 67.4%) who underwent surgical LER over a 5 year period in a single tertiary vascular institution were identified...
March 23, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#15
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28282229/evaluation-of-the-safety-of-early-compared-to-late-enteral-nutrition-in-canine-septic-peritonitis
#16
Jamie Elizabeth Hoffberg, Amy Koenigshof
Septic peritonitis is a relatively common condition in the veterinary intensive care unit, with a classically high mortality rate. Early enteral nutrition (EEN) in critically ill humans can lead to improved outcome. This study was performed to determine the safety of early postoperative feeding in canine septic peritonitis. In this retrospective case series, 56 dogs were identified. Sixteen dogs received EEN, defined as nutrition within 24 hr of surgery; 27 received late enteral nutrition (LEN) defined as nutrition more than 24 hours following surgery; and 13 dogs had no enteral nutrition in hospital (NEN)...
March 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28265730/does-beta-blockade-reduce-the-risk-of-depression-in-patients-with-isolated-severe-extracranial-injuries
#17
Rebecka Ahl, Galinos Barmparas, Louis Riddez, Eric J Ley, Göran Wallin, Olle Ljungqvist, Shahin Mohseni
BACKGROUND: Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury. METHODS: Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between 2007 and 2011...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28254961/impact-of-pre-admission-depression-on-mortality-following-myocardial-infarction
#18
Jens Sundbøll, Morten Schmidt, Kasper Adelborg, Lars Pedersen, Hans Erik Bøtker, Poul Videbech, Henrik Toft Sørensen
BackgroundThe prognostic impact of previous depression on myocardial infarction survival remains poorly understood.AimsTo examine the association between depression and all-cause mortality following myocardial infarction.MethodUsing Danish medical registries, we conducted a nationwide population-based cohort study. We included all patients with first-time myocardial infarction (1995-2014) and identified previous depression as either a depression diagnosis or use of antidepressants. We used Cox regression to compute adjusted mortality rate ratios (aMRRs) with 95% confidence intervals...
March 2, 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28216698/clinical-application-of-point-of-care-transthoracic-echocardiography-in-perioperative-period
#19
REVIEW
Swaroop Margale, Kurichi Marudhachalam, Sarvesh Natani
Transthoracic echocardiography (TTE) has established its role for diagnosis and management in cardiology and is used by various other specialities in medicine, but it is not routinely practised by anaesthesiologists in the perioperative period including the pre-admission clinic/outpatient clinic. The last decade has seen the emerging role of anaesthesiologist as a 'Perioperative physician'. This review article highlights the potential role and clinical utility, education, teaching and limitations of point of care (POC) TTE modality in perioperative care...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28145035/the-epidemiology-of-long-stay-patients-in-a-university-teaching-hospital
#20
Kim O'Sullivan, Johan Martensson, Raymond Robbins, K J Farley, Doug Johnson, Daryl Jones
BACKGROUND: Patients admitted to acute care hospitals may have multiple co-morbidities, and a small proportion may stay a protracted period. AIMS: To assess the proportion of hospital patients who are long stay (≥14 days), evaluate associations with baseline variables and subsequent in-patient morbidity and mortality. METHODS: Retrospective observational study of patients aged ≥ 18 years staying in hospital for at least 24 hr between 1-7-2013 and 30-6-2014...
February 1, 2017: Internal Medicine Journal
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